migraine headache vs. seizure headache

[Barb]

My 10 year old was diagnosed with Complex Partial seizures with 2nd generalization 2 years ago.  EEG and MRI were mildly abnormal.  SHe was fairly well controlled on depakote for a time , but have recently begun adding lamictal to try and regain control of frequent simple partial seizures.  Her symptoms consist of becoming very pale, nausea or stomach ache, extreme weakness and fatigue and a left eyelid droop.  She remains conscious.  SHe has recently been adding headaches to the mix.

My question concerns the headaches she has begun having.  Her dr. says when a h/a occurs with these other symptoms it is a migraine, not a seizure.  I am reluctant to accept that, as she looks the same to me-seizure like, whether she has a h/a or not.  How do we sort this out?

Thank you

[pjb217]

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[leej725]

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[kevin ward]

hello i got into a bad accident when i was very young. as a result i sufferd very excruciating head pain. i dont know if they
were seizure headaches or migraine headaches. it was pain that would make me cry.i think getting your daughters brain activity
monitored might tell you something.

[CCF Neuro[P] MD, RPS]

Dear Barb:

Sorry to hear about your daughter's epilepsy.  Migraine headaches can be associated with epilepsy.  They can either come before or after the seizure event.  These types of headaches are temporally related to the seizure event and for the most part do not occur without the seizure event.  Migraine headaches, are not associated with the seizure itself, in otherwords, the migraine event is not produced by the epileptiform discharges on the EEG (the exceptions would be benign focal discharges of childhood-which you daughter does not have, and benign occipital lobe epilepsy-which begins younger age group children).  The occurrance of migraine and epilepsy for most of the population who have both are separate entities.  There co-incidence is purely happenstance.  Migraines usually last longer, are not as frequent, have other signs that distinguish them such as photo or phonophobia, vascular quality (pounding), location (usually frontal or temporal) in pain, and nausea.  Interestingly, depakote has been shown to be an effective medication for migraine headaches.  Obviously, not too effective for your daughter.  

I would try and see if you could distinquish the migraines from her seizures by the differences in headache qualities, frequency of both, and the co-incidence of both together.  If there are still too many alike things, then she might have seizures which are producing her migraines.  One could also treat her with non=epilepsy medication and see if the migraines do not resolve.

I hope I helped alittle.

Sincerely,

CCF Neuro MD